Referral Coordinator II - PRN - Cancer Care

Overview Join to apply for the Referral Coordinator II - PRN - Cancer Care role at SSM Health

MO-REMOTE

Worker Type: PRN Job Highlights This is a PRN (as needed) position filling in open shifts during the week. The hours would be 7:30am-4pm and will support all 6 Care Care Infusion Centers. The position will be remote after training period. There are no guaranteed hours or benefits. Job Summary Coordinates provider referrals, pre-certifications, and pre-authorizations for managed care insurance plans. Responsibilities Attends in-services provided by various health plans. Travels to off-site locations as necessary. Gathers necessary clinical information and processes referrals, pre-certification, pre-determinations, and pre-authorizes according to insurance plan requirements. Logs, tracks and reviews managed care approvals and denials. Responds in a timely manner to last minute/emergency referrals or additional codes performed during a procedure, or procedural changes for pre-authorizations. Verifies insurance coverage, benefits and creatrs price estimates, reverifications as needed (ex; first of the month reverifications for managed Medicaid's). Works collaboratively with insurance companies, providers and staff to ensure plan requirements have been met prior to patient services being rendered in order to maximize reimbursement. Preregisters patients for appointments. Schedules patients for appointments appropriately. Performs all other duties as assigned. Education High School diploma/GED or 10 years of work experience Experience One year experience required Physical Requirements Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs. Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements. Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors. Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc. Frequent keyboard use/data entry. Occasional bending, stooping, kneeling, squatting, twisting and gripping. Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs. Rare climbing. Required Professional License And/Or Certifications None Department 6888000125 Oncology Network Work Shift Day Shift (United States of America) Scheduled Weekly Hours 0 Benefits SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members. SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Seniority level Entry level Employment type Part-time Job function Health Care Provider Industries: Hospitals and Health Care Missouri, United States $21.00-$24.00 2 weeks ago Montserrat, MO $7,200.00-$10,800.00 3 months ago Revenue Cycle Medical Billing Claim Status Medical Records St Louis, MO $2,500.00-$3,750.00 1 year ago #J-18808-Ljbffr SSM Health